How much rates vary
Facilitymedian $4,266 · 10th to 90th $955 to $14,125Professionalmedian $1,047 · 10th to 90th $708 to $1,479
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $794.33 Median $5,011.87 Typical High $11,220.18 | Facility | None | $794.33 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,023.29 | Professional | None | $794.33 | $794.33 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $7,413.10 Typical High $17,378.01 | Facility | None | $1,071.52 | $7,413.10 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,445.44 | Professional | None | $691.83 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $676.08 Typical High $912.01 | Professional | 62 · Two surgeons | $436.52 | $676.08 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $169.82 Typical High $239.88 | Professional | 80 · Assistant surgeon | $112.20 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $97.72 | $147.91 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $3,467.37 | Facility | None | $831.76 | $831.76 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,454.71 Typical High $3,715.35 | Facility | None | $630.96 | $2,454.71 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,698.24 | Professional | None | $794.33 | $1,023.29 | $1,698.24 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $5,011.87 | Facility | None | $1,995.26 | $3,548.13 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,548.82 | Professional | None | $831.76 | $1,023.29 | $1,548.82 |
United Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $9,120.11 | Facility | None | $870.96 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,621.81 | Professional | None | $776.25 | $1,000.00 | $1,621.81 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $398.11 Typical High $512.86 | Professional | 52 · Reduced service | $398.11 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $602.56 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $102.33 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $707.95 |
Where Indiana sits
The same service costs 6.6 times more in Oklahoma than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 34th of 51
$1,072
OK $3,802UT $575
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.